Large, painless anterior cervical hyperostoses produced dysphagia and aspiration in this series of two cases. Both patients exhibited ossification of the anterior longitudinal ligament of the spine. The literature pertinent to the arthrogenic causes of dysphagia is reviewed and the pathological anatomy, etiologies of osteophytic conditions, analysis of previously reported cases and a rational diagnostic approach to the problem are discussed. Surgical excision of the offending osteophytes is indicated in those patients who do not respond satisfactorily to conservative therapy.